Increased carotid intima-media thickness (cIMT) is reported in both adults and children with human immunodeficiency virus (HIV) in high income settings and is associated with an increased risk of cardiovascular disease, but data from sub-Saharan Africa is lacking.We assessed cIMT using ultrasound in perinatally HIV-infected children aged 6 to 16 years taking antiretroviral therapy (ART) for ≥6 months compared with HIV-uninfected controls in Harare, Zimbabwe. Groups were compared using unpaired t test and potential predictors of cIMT were assessed using multiple linear regression.A total of 117 participants with HIV, of whom 55 (45%) were female and 75 healthy uninfected controls were included. Participants with HIV were younger than uninfected controls, 10.7 (2.4) years versus 11.9 (2.6) years (P = .001). Mean cIMT was 0.40 (0.05) mm in those with HIV versus 0.40 (0.04) mm in healthy controls (P = .377). There was no association between cluster of differentiation 4 count, HIV viral load, and duration on ART and cIMT.Children with HIV taking ART have similar cIMT to uninfected children. Increasing numbers of children with HIV are reaching adulthood and longitudinal studies to assess the effect of long-term HIV and ART on vascular changes are required.
Objective: To describe the features of HIV-associated chronic lung disease (CLD) in older children and adolescents living with HIV and to examine the clinical factors associated with CLD. This is a post-hoc analysis of baseline data from the BREATHE clinical trial (ClinicalTrials.gov, NCT02426112). Methods: Children and adolescents aged 6-19 years were screened for CLD (defined as a FEV1 z-score <-1 with no reversibility post-bronchodilation with salbutamol) at two HIV clinics in Harare, Zimbabwe and Blantyre, Malawi. Eligible participants with CLD (cases) were enrolled, together with a control group without CLD (frequency-matched by age group and duration on ART) in a 4:1 allocation ratio. A clinical history and examination was undertaken. The association between CLD and a priori-defined demographic and clinical covariates was investigated using multivariable logistic regression. Results: Of the 1,585 participants screened, 419 (32%) had a FEV1 z- score <-1, of whom 347 were enrolled as cases (median age 15.3 years [IQR 12.7 -17.7]; 48.9% female), and 74 with FEV1 z-score>0 as controls (median age 15.6 years [IQR 12.1 -18.2]; 62.2% female). Amongst cases, current respiratory symptoms including cough and shortness of breath were reported infrequently (9.3% and 1.8%, respectively). However, 152 (43.8%) of cases had a respiratory rate above the 90th centile for their age. Wasting and taking second-line antiretroviral treatment (ART) were independently associated with CLD. Conclusions: The presence of CLD indicates the need to address additional treatment support for youth living with HIV, alongside ART provision, to ensure a healthier adulthood.
The Arctic Council is well-positioned to play a leadership role in better understanding the impact of Covid-19 in the Arctic and spearheading activities to respond to the pandemic in the short-, medium- and longer-term. This briefing document was prepared to inform initial discussions regarding the coronavirus pandemic in the Arctic at the Senior Arctic Officials’ executive meeting (SAOX) on 24-25 June 2020. It draws together available information – to date (June 2020) – about the impact of Covid-19 in the Arctic: Briefing Document for SAOs June 2020 For public release Page 10 of 83 Covid-19 and the actions taken to respond in the Arctic region. The document draws from a wide spectrum of sources, reflecting the complex and intricate nature of how Covid-19 affects Arctic peoples and communities, including national and subnational statistical databases and tools, peer-reviewed articles, policy statements, technical guidelines, field surveys, and local observations from Arctic communities.
The aim of the study was to assess temporal trends in health risks related to most common persistent contaminants, including polychlorinated biphenyls (PCBs), dichloro-diphenyl-trichloroethanes (DDTs), lead (Pb), as well as mercury (Hg) among indigenous peoples living in coastal areas of Chukotka in Arctic Russia. This is examined in relation to exposure pathways and a range of social and behavioral factors capable of modifying the exposure to these contaminants, including place of residence, income, traditional subsistence, alcohol consumption, and awareness of risk prevention. The primary exposure pathway for PCBs is shown to be the intake of traditional foods, which explained as much as 90% of the total health risk calculated employing established risk guidelines. Nearly 50% of past DDT-related health risks also appear to have been contributed by contaminated indoor surfaces involving commonly used DDT-containing insecticides. Individuals who practiced traditional activities are shown to have experienced a 4.4-fold higher risk of exposure to PCBs and a 1.3-fold higher risk for DDTs, Pb, and Hg. Low income, high consumption of marine mammal fat, alcohol consumption, and lack of awareness of health risk prevention are attributed to a further 2-to 6-fold increase in the risk of PCBs exposure. Low socioeconomic status enhances the health risks associated with exposure to the persistent contaminants examined. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
The aim of the study was to assess temporal trends in health risks related to most common persistent contaminants, including polychlorinated biphenyls (PCBs), dichloro-diphenyltrichloroethanes (DDTs), lead (Pb), as well as mercury (Hg) among indigenous peoples living in coastal areas of Chukotka in Arctic Russia. This is examined in relation to exposure pathways and a range of social and behavioral factors capable of modifying the exposure to these contaminants, including place of residence, income, traditional subsistence, alcohol consumption, and awareness of risk prevention. The primary exposure pathway for PCBs is shown to be the intake of traditional foods, which explained as much as 90% of the total health risk calculated employing established risk guidelines. Nearly 50% of past DDT-related health risks also appear to have been contributed by contaminated indoor surfaces involving commonly used DDT-containing insecticides. Individuals who practiced traditional activities are shown to have experienced a 4.4-fold higher risk of exposure to PCBs and a 1.3-fold higher risk for DDTs, Pb, and Hg. Low income, high consumption of marine mammal fat, alcohol consumption, and lack of awareness of health risk prevention are attributed to a further 2- to 6-fold increase in the risk of PCBs exposure. Low socioeconomic status enhances the health risks associated with exposure to the persistent contaminants examined.
Aluminium (Al) is a non-essential neurotoxicant and there is limited information regarding exposure to Al in utero. This study sought to evaluate the in utero exposure to Al in urban South African women, its effects on birth outcomes and possible synergistic effects between Al, essential and neurotoxic elements such as lead (Pb), mercury (Hg) and arsenic (As), as well as a a potential sex-dependent response to these elements in neonates. This study has found elevated levels of Al in urban women at delivery. The Spearman’s rank correlation coefficients (p-value) of the association between maternal serum Al and birth outcomes (gestational age and parity), and between maternal serum Al and Cu, Zn and Se, were statistically significant. However, in the general and the stratified models, no association was found between any of the birth outcomes and maternal serum Al. The association between maternal serum Al and neurotoxic elements at delivery showed a significant positive correlation for Pb only (rho = 0.361; p < 0.001) which was found to be sex-dependent in neonates (males, rho = 0.285; p < 0.004 and females, rho = 0.444, p < 0.001). Our preliminary findings indicate that in utero exposure to Al is an emerging concern requiring further research and directives from public health authorities.
Fish muscle may constitute one of the main sources of iodine (I) for the indigenous peoples of the Russian Arctic, although limited information is available about its content in commonly consumed fish species. In the current study, bromine (Br), I, the essential elements (copper, selenium and zinc) and other non-essential elements — specifically mercury, arsenic (As), cadmium, lead and nickel — have been quantified in 10 fish species consumed by people living in the Nenets and Chukotka Regions. Fish muscle was analysed by ICP-MS after nitric acid or tetramethylammonium hydroxide digestion. Certified reference materials were employed and concentrations are reported as geometric means (GMs). Atlantic cod (6.32 mg/kg) and navaga (0.934 mg/kg) contained substantially higher amounts of I than all other fish species, while broad whitefish had the lowest (0.033 mg/kg). By comparison, navaga contained more Br (14.5 mg/kg) than the other fish species, ranging 7.45 mg/kg in Atlantic cod to 2.39 mg/kg in northern pike. A significant inter-fish association between As and I in freshwater and marine fish was observed, suggesting common sources and perhaps parallel absorption patterns. Only Atlantic cod and, to lesser extent, navaga constituted significant dietary sources of I.
This year marks 30 years of close collaboration between a consortium of institutions, namely, the Northwest Public Health Research Center, Saint-Petersburg (NWPHRC); the Institute of Community Medicine (ICM) of UiT (The Arctic University of Norway, Tromsø); the National Institute of Occupational Health (NIOH), Oslo; the University Hospital of Northern Norway (UNN) at Tromsø; and McMaster University (MU), Hamilton, ON, Canada. During the early years of cooperation, Dr. Chashchin was the Director of the Scientific Laboratory of the North-West Public Health Centre Branch of the NWPHRC located in the town of Kirovks in the Murmansk Region. The primary focus of this long-standing collaboration was to assess and address issues that are important for maintaining the health of the population living in the border areas of Russia and Norway and included the reduction of occupational health risks among workers employed in mining, metallurgical and machine-building enterprises located in the north-western region of Norway and the adjoining Kola Peninsula in Russia. These industrial activities constituted essential components of the local industries. The ongoing Russian–Norwegian cooperation in the field of occupational medicine is an excellent example of the effective combination of intellectual potential and research technologies of multiple countries. It has resulted in the development of a scientifically based set of measures for practical implementation, contributing to the improvement of working conditions and preservation of the health of workers employed at enterprises where the joint research was carried out.
Currently, monitoring of persistent organic pollutant (POP) content in various biological and environmental matrixes in the Arctic is an urgent task. The present study focused on the determination of POPs such as: PCB#28, PCB#52, PCB#101, PCB#105, PCB#118, PCB#123, PCB#153, PCB#128, p,p’-DDE, o,p’-DDE, p,p’-DDD, o,p’-DDD, hexachlorobenzene (HCB), cis-nonachlor, trans-nonachlor, cis-chlordane, trans-chlordane, mirex, 1,2,3,5-tetrachlorobenzene and 1,2,4,5-tetrachlorobenzene in fish consumed by the indigenous people of the Nenets Autonomous Okrug (NAO) of the Russian Arctic. Fish samples were analyzed by gas chromatography triple quadrupole mass spectrometry (GC-MS/MS) using the multiple reaction monitoring (MRM) technique. The obtained results show that the major POPs in fish were dichlorodiphenyltrichloroethane (DDT) breakdown products and polychlorinated biphenyls (PCB) congeners. The ∑PCB8 in pink salmon, Arctic char, navaga, humpback whitefish and northern pike were 1.54, 1.58, 1.24, 0.72 and 0.32 ng/g (ww), respectively. The main PCB congeners maximum average medium concentrations were 0.68 ng/g (ww) and 0.51 ng/g (ww) of PCB#153 in navaga and PCB#128 in pink salmon, respectively. The main DDT breakdown product was p,p’-DDE. In Arctic char, pink salmon, navaga, humpback whitefish and northern pike, the concentration of p,p’-DDE was 0.58, 1.61, 0.49, 0.63 and 0.08 ng/g (ww), respectively. A moderate positive relationship between ∑PCB8 and lipid content and a high positive relationship between ∑DDT and lipid content were observed. In fish samples with fat content <0.5% (northern pike, humpback whitefish), the amount of analyzed POPs was 2 or more times lower than that in fish species with fat content >1% (pink salmon, Arctic char). Despite the large number of fish in the diet of indigenous peoples from NAO, no significant risks were identified. Most legacy POP and organochlorine pesticides (OCPs) tend to decrease, which can be explained by past national and regional bans and restriction on their use and emission.
Currently, adipose tissue is considered an endocrine organ that produces hormone-active substances, including leptin, which can play a key role in thermoregulation processes. Therefore, we performed a meta-analysis to investigate the influence of the climatic environment on leptin levels. A systematic literature search in the databases was carried out on 10 January 2020. Finally, 22 eligible articles were included in the current meta-analysis and a total of 13,320 participants were covered in the final analysis. It was shown that males of the “North” subgroup demonstrated significantly higher levels of leptin (10.02 ng/mL; CI: 7.92–12.13) than males of the “South” subgroup (4.9 ng/mL; CI: 3.71–6.25) (p = 0.0001). On the contrary, in the female group, a similar pattern was not detected (p = 0.91). Apparently, in order to maintain body temperature, higher leptin levels are required. The results of the study indicate that such effects are most pronounced in males and to a smaller extent in females, apparently due to a relatively high initial concentration of leptin in females. The correlation between leptin levels and climatic environment data support the hypothesis of leptin-mediated thermoregulation as an adaptive mechanism to cold climates.
We give a description of Automated information system of the management of the municipal solid waste collection, its basic models and applications. We provide also a short survey of publications on the problem
The purpose of the study is to assess the factors that affect the level of overall mortality in the Republic of Bashkortostan (RB). Methods. The study was conducted using regression analysis based on panel data. The official statistical materials of the Territorial body of the Federal state statistics service for the Republic of Belarus were used as an information base (table C51; databases on demography and statistical yearbooks "Socio-economic situation of municipal districts and urban districts of the Republic"; annual statistical reports in the form "2TP - Air"); Rosstat. We considered data consisting of observations for 54 municipalities and 21 cities of the Republic of Belarus, followed in dynamics for 16 years (2002-2017). There are 17 indicators that characterize the main aspects of national development. Results. Based on the regression analysis of panel data, risk factors for overall mortality were identified: primary access to disability of the adult population, the number of pensioners, unemployment, and crime. It is noted that improving the quality of medical services, increasing the number of enterprises, and population density affect the reduction of the death rate. The impact of these factors differs for men and women. Conclusion: the results of the assessment allow us to identify areas of activity for reducing mortality, as well as to determine the priorities of socio-economic policy at the regional level.
The paper presents experience in probabilistic linkage of the records in the Arkhangelsk County Birth Registry with regional infant mortality data. Practical issues of the procedure of independent depersonalized datasets linkage are discussed. Two datasets have similar indirect identifiers that were used to match the records. The combined database contains information on maternal health and pregnancy outcome as well as infant health. Also, it includes data on infant's age at death and cause of death. Our experience can be useful for researchers dealing with registry-based studies in settings where personal identification numbers are not available. Linked data sets give an opportunity to explore risk factors of neonatal and infant death and to investigate survival in newborns having different health problems, including prematurity. Our experience can be used for development of large birth cohorts using the data from the population-based birth registries in the Russian North as baseline for studying long-term effects of factors during pregnancy on health later in life.
Objective: to assess the prevalence and risk factors of such pathology as a newborn who is underweight for gestational age (GA). Materials and methods: we used data on live-born full-term children from a single pregnancy registered in the birth register of the Arkhangelsk region for 2012-2015 (n=52,149). Socio-demographic, medical, and lifestyle-defining characteristics of the mother were evaluated. Differences between groups of children with and without the studied pathology were determined on the basis of Pearson's χ2 criterion. Unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI) were determined using multivariate logistic regression analysis. Results: 3.3% (n=1696) of children were underweight for GA. Risk factors for the birth of a small child for GW were the mother's low level of education (OR=1.32 [95% CI 1.06; 1.64]), and her lack of work (OR=1.2 [95% CI 1.06; 1.37]), Smoking (or=1.99 [95% CI 1.75; 2.27]), alcohol abuse (OR=2.01 [95% CI 1.14; 3.56]), low body weight (OR=1.5 [95% CI 1.27; 1.78]), first delivery (OR = 1.61 [95% CI 1.44; 1.80]), presence of chronic arterial hypertension in a pregnant woman (OR=1.99 [95% CI 1.52; 2.61]), preeclampsia/eclampsia (OR=2.26 [95% CI 1.8; 2.84]). The risk was also increased in the presence of a congenital malformation (CRD) in a child (OR=1.49 [95% CI 1.18; 1.87]). Conclusion: socio-demographic and lifestyle factors of the mother, as well as chronic arterial hypertension and preeclampsia/eclampsia in the mother and the presence of congenital malformation (CM) in the child increase the risk of having children who are not very heavy for GA.
ntroduction: Studies have shown that welders have increased cardiovascular mortality. This may be due to airborne particulate matter (PM) exposure. Elevated levels of PM in polluted urban air have been associated with increased cardiovascular mortality and morbidity. This study seeks to explore potential mechanisms for the increased cardiovascular mortality in welders.
Methods: Seventy welders were compared to 74 referents. Exposure to PM was assessed by personal full-shift sampling of work room air the last 2 days before collection of blood samples. Selected biomarkers of pro-coagulant activity, endothelial/platelet activation and systemic inflammation were determined in the samples.
Results: The welders had been occupationally exposed to PM for 15 years on average. The geometric mean current exposure to PM was 8.1 mg/m3. They had statistically significantly higher concentrations of TNF-α, P-selectin, CD40L, prothrombin fragment 1 + 2 and D-dimer than the referents. Increasing concentrations of D-dimer and CD40L were observed by increasing current exposure to PM.
Discussion: The study shows that welders highly exposed to welding PM were in a pro-thrombotic state with increased thrombin generation and consequently higher D-dimer concentrations. The welders had also increased endothelial/platelet activation as compared to the referents. These alterations are compatible with increased cardiovascular mortality as previously reported among welders.
The raw concentration data for the research article entitled "Essential and non-essential trace elements in fish consumed by indigenous peoples of the European Russian Arctic" (Sobolev et al. 2019) are herein presented. Fifteen fish species were collected in the Nenets Autonomous and Arkhangelsk Regions of the Russian Federation and were analysed for 9 elements (As, Cd, Co, Cu, Hg, Ni, Pb, Se and Zn). The sampling sites were located in the European parts of the Russian Arctic and sub-Arctic territories. Within these territories, Nenets indigenous peoples commonly catch and consume local fish. Based on questionnaire data, local fish sources constituted ∼ 90% of the total fish consumed by endemic individuals living in these regions. The data summarized in this publication fill a gap in knowledge.
The aim of this study was to explore health worker’s perception of using manual vacuum aspiration (MVA) 1 year after an educational intervention. The health personnel in Malawi who treat women with incomplete abortions are medical interns, clinical officers and nurses/midwives. The training was designed as a refresher course as health personnel usually are trained how to do MVA during their studies. Altogether, 53 health personnel received the training and filled out questionnaires on knowledge, attitude and practice before the training had started. After 1 year, focus group discussions were arranged with 33 of the previously trained health personnel. There was an almost equal number of nurses, clinical officers and medical interns in the survey and in the focus groups, which included fairly equal numbers of male and female participants and a good age spread among the participants. Even though the participants demonstrated knowledge on the benefits of using MVA prior to the training, most of the health personnel used curettage because of a lack of confidence, broken equipment and high gestational age of the expectant mothers. The training sessions were considered useful, but could have been extended to several days and have included actual patients. Our findings provide important insight on how to proceed in improving post-abortion care in a country where complications of unsafe abortion are common and the health system is low on resources.
One of the most worrying consequence of the production and use of persistent organohalogen pollutants (POPs) is the high accumulation in Arctic populations because of long-range transport. Study of the effects in these populations may illustrate human impacts that are difficult to assess in other locations with lower exposure to these compounds and more diverse pollutant influences.
The maternal accumulation patterns of POPs were mainly related with residence. Most of these compounds were found in higher concentration in women living at coastal areas except 4,4'-DDE and 4,4'-DDT which were of inland origin. This last pesticide was the pollutant showing positive associations with gestational age and newborn's weight and length. To the best of our knowledge, this is the first study reporting statistically significant associations between maternal 4,4'-DDT exposure and anthropometric characteristics of the newborns
In present study, the analyses of essential [copper (Cu), cobalt (Co), selenium (Se) and zinc (Zn)] and nonessential elements [mercury (Hg), lead (Pb), cadmium (Cd) and arsenic (As)] in 7 fish species consumed by the indigenous people of the European Russia Arctic were conducted. The Nenets Autonomous Region, which is located in the north-eastern part of European Russia, was chosen as a Region of interest. Within it, the Nenets indigenous group (n ¼ 6000) constitutes approximately 10% of the total population. Nearly all of the Nenets live a traditional life with fish caught in the local waters as a subsistence resource. We found that northern pike contained twice the amount of Hg compared with roach, and 3e4 times more than other fish species commonly consumed in the Russian Arctic (namely, Arctic char, pink salmon, navaga, humpback whitefish and inconnu). Fish Hg concentrations were relatively low, but comparable to those reported in other investigations that illustrate a decreasing south-to-north trend in fish Hg concentrations. In the current study, northern pike is the only species for which Hg bioaccumulated significantly. In all fish species, both Cd and Pb were present in considerably lower concentrations than Hg. The total As concentrations observed are similar to those previously published, and it is assumed to be present primarily in non-toxic organic forms. All fish tissues were rich in the essential elements Se, Cu and Zn and, dependent on the amount fish consumed, may contribute significantly to the nutritional intake by indigenous Arctic peoples. We observed large significant differences in the molar Se/Hg ratios, which ranged from 2.3 for northern pike to 71.1 for pink salmon. Values of the latter 1 appear to enhance the protection against Hg toxicity. © 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
The aim of the study was to assess temporal trends in health risks related to most common persistent contaminants, including polychlorinated biphenyls (PCBs), dichloro-diphenyl-trichloroethanes (DDTs), lead (Pb), as well as mercury (Hg) among indigenous peoples living in coastal areas of Chukotka in Arctic Russia. This is examined in relation to exposure pathways and a range of social and behavioral factors capable of modifying the exposure to these contaminants, including place of residence, income, traditional subsistence, alcohol consumption, and awareness of risk prevention. The primary exposure pathway for PCBs is shown to be the intake of traditional foods, which explained as much as 90% of the total health risk calculated employing established risk guidelines. Nearly 50% of past DDT-related health risks also appear to have been contributed by contaminated indoor surfaces involving commonly used DDT-containing insecticides. Individuals who practiced traditional activities are shown to have experienced a 4.4-fold higher risk of exposure to PCBs and a 1.3-fold higher risk for DDTs, Pb, and Hg. Low income, high consumption of marine mammal fat, alcohol consumption, and lack of awareness of health risk prevention are attributed to a further 2- to 6-fold increase in the risk of PCBs exposure. Low socioeconomic status enhances the health risks associated with exposure to the persistent contaminants examined.
HIV disrupts host defense mechanisms and maintains chronic inflammation in the lung. Nitric oxide is a marker of lung inflammation and can be measured in the exhaled air. We investigated the relationship between exhaled nitric oxide (eNO), and airway abnormalities in perinatally HIV-infected children aged 6–19 years. In total, 222 HIV-infected and 97 HIV-uninfected participants were included. Among HIV-infected participants, 57 (25.7%) had a history of past TB; 56 (25.2%) had airway obstruction, but no prior TB. HIV status was associated with lower eNO level [mean ratio 0.79 (95% confidence interval, 95% CI 0.65–0.97), P = 0.03]. Within the HIV-infected group, history of past TB was associated with lower eNO levels after controlling for age, sex and time of eNO testing [0.79 (95% CI 0.67–0.94), P = 0.007]. HIV infection and history of TB were associated with lower eNO levels. eNO levels may be a marker of HIV and TB-induced alteration in pulmonary physiology; further studies focused on potential causes for lower eNO levels in HIV and TB are warranted.